期刊
BEHAVIOURAL BRAIN RESEARCH
卷 414, 期 -, 页码 -出版社
ELSEVIER
DOI: 10.1016/j.bbr.2021.113507
关键词
Schizophrenia; Antipsychotics; Atypicality; Treatment
资金
- Canadian Institutes of Health Research (CIHR) [PJT-153262]
- University of Toronto
- Research Hospital Fund-Canada Foundation for Innovation RHFCFI
- Department of Psychiatry, University of Toronto
- Banting and Best Diabetes Center (BBDC)
- PSI foundation, Ontario
- Kelly and Michael Meighen Chair in Psychosis Prevention
- Cardy Schizophrenia Research Chair
- Canadian Institutes of Health Research
- CAMH Discovery Fund
The introduction of chlorpromazine led to schizophrenia being repositioned as a biological illness. The evolution of antipsychotics, from 'typical' to 'atypical', and drug development that aligns with the illness' heterogeneity and complexity are explored. It may be time to reconsider the notion of developing drugs that specifically treat 'schizophrenia'.
The introduction of chlorpromazine and the work that ensued provided the foundation to reposition schizophrenia as a biological illness. The present paper follows the evolution of antipsychotics and their shift from 'typical' to 'atypical'. Atypicality is reviewed in reference to its original definition, clozapine's role, and developments that now leave the concept's utility in question. In a similar fashion, drug development is reviewed in the context of the illness' multiple symptom domains, as well as differences captured by clinical staging and phenotyping. Collectively, the evidence argues for a more nuanced approach to drug development that aligns with the illness' heterogeneity and complexity. Just as 'atypical' as a descriptor for antipsychotics may be outdated, it may be time to set aside the notion of developing drugs that treat 'schizophrenia'.
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